The concept of the ethics and the law play a very essential role towards the provision of the guidance in the conduct and the behaviour of the individual who are working in the system of the health care. As per the given case study the enrolled nurse of the organization initiated the practise of the nursing or the health care activities going out of her permitted scope of the practise. She has initiated to independently administer the intravenous solution of glutathione for the individual at her home. She has violated the regulations and the norms and the breach of the standard 1 of the standards of the practises for the midwives and the nurses and the midwives with generic skills and the core competencies for the enrolled nurses (Gower et al., 2017). Some of the factors of the core competencies of the enrolled nurses includes their working under the profession supervision of the registered nurses which this particular nurse has violated (Koshy et al., 2017). Furthermore the enrolled nurse like this particular nurse are generally accountable for all the aspects of the delegated are within their limited scope of the practises as their educational preparation, their experiences and the standards of the practises for the midwives and the nurses.
As per the case study as illustrated above the nurse has violated both the core competencies and the generic skills as per the Singapore nursing board and the regulations of the nursing and the midwives norms.
While the context of the are organised and divided in three of the major domains , some of the actors that the nurse has violated can be summarized below.
The professional, ethical and the legal nursing practices are one of the standards of the competency for the enrolled nurse that includes the indictors of the competency which the nurse has violated.
Another standard that the nurse has violated includes management of the care and the related professional development that includes the responsibility of each and every enrolled nurse to inform the seniors and the registered nurse before taking any of the action related toe patient and their care and also the medicine and their dosage before taking any sort of action
Some of the generic skills of the enrolled nurses as per the Singapore nursing board that the nurse has violated includes performance of the nurse under the supervision of the senior. This mean that the nurse should have perform the skills independently only under the supervision and the deligation of a senior or a registered nurse either directly or indirectly. Further generic skills that has been hampered includes the factor that the enrolled nurses should only perform any of the skills related to the patients care or medical dosage only as the assistant to the registered nurse (Gower et al., 2017). The nurse furthermore has violated the generic skills and the norms of the enrolled nurses of the country by not taking any of the data or the information prior injecting the intravenous solution. The nurse should have taken in accent of the temperature, the respiration the blood pressure, the pain the pulse in the oximetry (Koshy et al., 2017). The nurse should however take care of the safety and the comfort of the client together with the mobility and the ambulation of the patient before the injection of the intravenous solution.
The code for the midwives and the nurses generally sets out the professional level of the conduct, the practising stands, and the ethical values that each and every nurses and the midwives of the Singapore generally tend to act upon and uphold. There includes four of the major regulatory and the ethical provision of the Singapore (Singapore Government, 2012). These are the nurses and the people, the nurses or the midwives and their practices, the nurses or the midwives and their profession and the nurses or the midwives and co-workers.
Some of the principles from the SNB code for nurses and the midwives that the nurse of the given vase study breached includes the following.
The enrolled nurse of the given case study should have responsible and accountable enough for her judgments, decision and their actions. She must have ensure that the patient have received safe, effective and ethically appropriate care under the supervision of a senior nurse.
It is furthermore the responsibility of the enrolled nurse to evaluate her knowledge and her skills as well as the effectiveness of the care that is provided by her. She should have maintained her competencies through the continuous education, the improved quality activities and the lifelong learning (Singapore Government, 2012).
The nurse should have ensured that all the records are complete, accurate and timely in nature. She should have made some of the relevant entries as per the date, time within the supervision of a registered nurse.
The nurse of the case study should have been responsible and accountable for the self, and the professional maintenance of the competencies and also the continuous personal and the professional growth. The nurse has violated this principle by not practising within her own level of competencies and the scope of the practices (Singapore Government, 2012).
According to ANA (2015), the health and the wellbeing of each and every individual is one of the first priority in the world. As per the United Nations declaration of the human rights, each and every person has their rights to safe and wellbeing and the right of life. In the study by Koshy et al. (2017) the author highlighted the fact how the nursing practise and the limits of the enrolled nurses falls short in case of the emergencies. For this kind of scenario its is thus important to take care of the emergency medical need of the patient than the professional limitation. The author furthermore stated how it is also essential to take in account of the help and the supervision of the registered nurses in case of the emergencies to avoid further mishaps sine the enrolled nurses have little authority of the patient care and medical dosage. With reference from the national and the internal literature it can thus be stated that the nurse who have violated the norms and the code of the practise, has done this to ensure that the patient gets her requirements or needs (Wu et al., 2015). She has adhere to the respect for the patient’s need, values and the rights with the provision of the effective are that is determined by the value, the needs without any kind of unfair or the prejudicial discrimination over the basis of the ethnicity, the gender , the religion , the age, the economic status and the attributes and the preferences (Stan?i? et al., 2016). She has ensured to treat her patient with respect and for the sake of the humanity she has ensured to fulfil the emergency need of the patient which required her to inject the intravenous solution of Glutathione irrespective of knowing that being an enrolled nurse she does not have the authority to take these actions or do any of the practises without the permission or the supervision of the registered nurse.
The role of the complaints committees in the health care regime and also the nursing practises includes the identification of any sort of violation of the regulations and the norms by the health care professionals within the nursing and the health care practise (Gower et al., 2017). The function of the complains committee is to develop the principles and the norms related to the registered nursing professions and the enrolled nursing practises and evaluate any sort of discrepancies and the complains regrading ant of the misuse or ineffective health are practises done towards any patent of the registered organization. The committee takes in consideration of the norms and the values of the registered nurses and the midwives for the effective evaluation of the proficiency and the level of professionalism and the quality of the productivity of the health care professional s and the nurses within the organization in Singapore.
The above vase study is the demonstration of the sheer irresponsibility and the lack of the proper knowledge regarding the nursing practises within the health care practises. With the respect to the new codes for the nurses and the midwives, the principles that this registered nurse violated includes the principle 5 which is the practise in a responsible and accountable manner, principle 6 that illustrate the maintenance of the competency in the care of the people and principle 7 which states that the nurses should maintain clear and accurate records of the patient. It is the responsibility of the nurse to ensure that the patients are safe, effective and ethically appropriate in the care (Simmons et al., 2016). This is because it is essential as per the code of the practise of the nurses and the midwives that all the health care practises are carried out in the accordance with the ethical principles, the policies of the institution and the requirements. Furthermore it is also essential for the registered nurses to evaluate their knowledge and their skills for the effective care of the patient (Koshy et al., 2017). The violation of the norms and the principles that the registered nurse did by false charting the parameters of the patient without analysisnga and ensuring them has resulted the nurse to violate he major factors and the norms of the code for the nurses and the midwives.
The registered nurse failed towards the provision of the effective care within an accountable and responsible manner breaching the value statement 5 of the code of the ethics and the professional conduct (Board, 2012). Her actions includes sheer irresponsibility since she has been reported to have falsely charted the parameters and the records related the patient without even entering the room of the patient. This action of her has led her registration to get suspended for the period of 8 months. In this section some of the possible reasons will be analysed regarding the actions that the nurse have taken breaching the statement 5 of the code of the ethics and the professional conduct with the context of some of the literary norms and actions (Simmons et al., 2016).
According to the joint Commission or Accreditation of the Health care organizations, one of the major reason behind these kind of activity is sheer negligence. According to the insight of Wu et al., (2015) negligence is the failure for using such care as the reasonably prudent and the careful person for using under similar circumstances. The improper or unethical conduct together with the unreasonable lack of the skills of the nurse has resulted in these kind of actions. According to the research study by Effken et al., (2016) , one of the main factor that led the psychological hampering of the nurses resulting them to be unfocused and distracted from their responsibility towards the patients is the continuous bullying of the doctors. According to the research study on more than 10 hospitals, the nurses both the registered and the enrolled ones reported how they have been the victim of the doctor bullying which is still veiled as the organization’s silence. This is because many of the nurses tends to get afraid to report against the doctors since they believe that the administrators of the health care organization will refuse to admit their actions. The nurses in turn showcase their frustrations over the working pattern by neglecting their works. Furthermore factors such as long working hours, lack of proper staffs and adequate helping hands are some of the major factors that led he nurses to go fail towards fulfilling their responsibilities towards the patient. According to Ariyaratne et al., (2015) the registered nurse of the case study as described might be facing several issues within the nursing practises. These might include factors such as the low level of prestige, poor perception of the public, the issues related to the finances, the heavy level of the workload, the stressful conditions and the lack of the proper professional gratifications which is furthermore coupled with the shortage of the nursing professionals un the emergency wards. Besides these factors, poor level and the quality of the education and the training of the professional nurses furthermore might play an important role towards the reluctance and the irresponsible nature of the nurse. According to Gantz et al. (2012) , the poor public perception of the profession of the nursing together with the heavy rate of the financial constraints might also be one of the facto that has been influencing the specific registered nurse towards doing her activity effectively. Furthermore the lack of the professional gratification and the stress working conditions might also led the nurse to violate the basic norms of the collection and the maintenance of the accurate data for each and every patients of the ward.
It is the responsibility of the registered nurses to utilise the evidence based knowledge of the nursing and the judgements related to the professional nursing for assessing the health need, provision of the nursing care, the education of the clients and the supporting of individual for the management of the holistic health practises. There are various domains and indicators within the principles of the core competencies and the generic skills for the registered nurses (Board, 2012). These set of the minimum standards define the required qualities, the skills and the abilities of the registered nurses for the practise in Singapore. The four of the major competency domain of the registered nurses in the Singapore includes the professional, legal and the ethical practise of nursing, the management of the care, the leadership and the management of the nursing and the professional development. Some of the domain or the standards of the competencies that the registered nurse has violated or breached as per the given case stud includes the following.
There are many of the principles from the new SNB code for the nurses and the midwives that will help me to act and make my decisions for acting in this situation (Gower et al., 2017). This includes the principle 5- the practise in a responsible and the accountable manner, to ensure that the practise of the nursing is being carried out in accordance with the ethical principles, the institutional policies and the requirements. Furthermore I should have considered the principle 6 which is the maintenance of the competency in the care of the people. This principle includes the ensuring of the practises that best on the prevailing clinical guideline practises and the obtaining of the honest motive towards the practises of the nursing towards the needs and the values of the patient.
References
ANA. (2015). Nursing Scope and Standards of Practice. Retrieved from https://www.iupuc.edu/health-sciences/files/Nursing-ScopeStandards-3E.pdf
Ariyaratne, M. H. J. D., Gunasekara, T. D. C. P., Weerasekara, M. M., Kottahachchi, J., Kudavidanage, B. P., & Fernando, S. S. N. (2015). Knowledge, attitudes and practices of hand hygiene among final year medical and nursing students at the University of Sri Jayewardenepura.
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